EGFR、Her-2、HIF-1α、p53对进展期食管鳞癌新辅助化疗疗效的预测价值  

The application of EGFR,Her- 2,HIF- 1 alpha,p53 for neoadjuvant chemotherapy curative effect prediction in advanced esophageal squamous carcinoma

作　　者：丁兆军[1] 孟令新[1] 周晓明[1] 成之福[1] 王刚平[1] 张红[1] 薛英杰[2] 

机构地区：[1]日照市人民医院肿瘤科,山东日照276826 [2]济宁医学院(日照校区)医学信息工程学院,山东日照276826

出　　处：《现代肿瘤医学》2016年第20期3209-3212,共4页Journal of Modern Oncology

基　　金：济宁医学院面上项目(编号:JY2013KY061)

摘　　要：目的:探讨食管鳞癌相关因子EGFR、Her-2、HIF-1α和p53对进展期食管鳞癌新辅助化疗疗效的预测价值。方法:回顾性分析日照市人民医院2011年1月-2015年1月行紫杉醇联合顺铂方案新辅助化疗的进展期食管鳞癌(Ⅲ期)患者94例,采用免疫组化方法检测食管鳞癌组织中EGFR、Her-2、HIF-1α和p53的表达情况,应用RECIST1.1标准和病理组织学相结合方法行化疗疗效评估,Logistic多因素回归分析各指标与化疗疗效关系。结果:本研究组患者新辅助化疗总有效率为56.38%(53/94),全部为部分缓解。疾病稳定占41.49%(39/94),疾病进展占2.13%(2/94)。新辅助化疗前后各因子表达差异无统计学意义(均P>0.05)。Her-2表达阳性、阴性者化疗有效率分别为81.82%(9/11)、53.01%(44/83),两者比较差异有统计学意义(P=0.01)。p53表达阳性、阴性者化疗有效率分别为31.37%(16/51)、86.05%(37/43),两者差异有统计学意义(P<0.01)。Her-2阳性表达同时p53阴性表达者7例,其中化疗有效5例。EGFR和HIF-1α表达与化疗敏感性无关(P>0.05)。多因素分析显示,Her-2和p53是新辅助化疗的独立影响因素(均P<0.05)。结论:Her-2和p53作为新辅助化疗独立影响因子,可在化疗前对疗效进行预测,可能对患者新辅助化疗选择提供临床依据。Objective： To investigate the predictive value of neoadjuvant chemotherapy （ NAC） curative effect of EGFR,Her-2,HIF -1 alpha and p53 in advanced esophageal squamous cell carcinoma （ESCC）. Methods： Retro-spective analysis was studied for 94 cases advanced esophageal squamous cell carcinomas （ IH period） from January 2011 to January 2015. These patients were treated by neoadjuvant chemotherapy （paclitaxel plus cisplatin regimen）. Expression of EGFR, Her - 2, HIF - 1 alpha and p53 was detected by immunohistochemical method. RECIST1. 1 standard combined with pathological histology was applied to evaluate chemotherapy （ CT） curative effect. Logistic multifactor regression analysis was applied to investigate the relationship of these index. Results ： The total effective rate was 56. 38% （53/94） ,all were partial response. Stable disease accounted for 41.49% （39/94） ,disease progres-sion was 2. 13% （2/94）. There had no statistical significance for each factor expression differences before and after neoadjuvant chemotherapy （P 〉 0. 05 ） . The chemotherapy effective rate was 81.82% （9 /1 1 ） and 53. 01 % （44/83 ） in Her-2 positive and negative expression respectively （P = 0. 01 ） . The chemotherapy effective rate was 31.37% （16/51） in p53 positive expression patients, significantly lower than the negative expression of 86. 05% （37/43） （ P 〈 0. 01） . Her - 2 positive expression and p53 negative expression of 7 cases ,5 cases of effective chemotherapy. EGFR and HIF - 1 alpha expression has nothing to do with the sensitivity of chemotherapy （P 〉 0 .0 5 ） . Multiple factors a-nalysis showed that Her -2 and p53 were independent factors of neoadjuvant chemotherapy （P 〈0. 05） . Conclusion：Her -2 and p53 as independent factors of neoadjuvant chemotherapy, can predict the curative effect before chemother-apy. It is likely to provide clinical evidence for the selection of neoadjuvant chemotherapy of advanced eso

关 键 词：食管鳞癌 新辅助化疗 预测因子 表皮生长因子受体 人类表皮生长因子受体2 缺氧诱导因子1Α P53 

分 类 号：R735.1[医药卫生—肿瘤]